Clinical Denial Analyst (RN)

Incentives:

Eligible for evening/night, weekend shift incentive based on company policies and applicable job codes. Additional details will be provided during the interview process.

 

Bonus:

Potential for a performance-based bonus, subject to eligibility criteria and achievement of defined metrics. Details regarding bonus eligibility and performance goals will be provided during the interview process or upon hire.

 

Benefits:

We pride ourselves in retaining our top talent by offering work environments that support professional development and personal success. In addition to our robust healthcare and retirement plans, we offer:

• Flexible work schedules – Full time/part time/supplemental – Day/Eve/Night
• Onsite children’s care centers (Infant through Pre-K)
• Tuition reimbursement 
• Payactiv-earned wage benefit-work today, get paid tomorrow
• Free access to fitness centers
• Career advancement opportunities

 

Explore All Benefits:

https://www.deaconess.com/For-You/Employees/Employee-Benefit-Resources/Documents  

 

Job Overview:

This position is responsible for working assigned denials (such as no authorization, medical necessity, and readmission) from assigned work queues according to policy and established productivity standard. This position will work with third party payors to obtain payment on accounts according to legal and proper collection techniques as well as maintain accounts receivable goals developed by the department. The Coordinator will prepare appeals, reports of denial activity and identify trends for the Denial Analysis Team to make appropriate changes to prevent future denials.

Required: Certifications/Licenses/Experience:

• Active Registered Nurse (RN) in Indiana or other compact licensure state

 

Preferred Certification/License/Experience:

• BSN
• Three (3) to five (5) years of clinical experience as a Registered Nurse in an acute care or specialty hospital
• Minimum of two (2) years performing utilization review, charge audit, case management or similar functions in an acute care or specialty hospital
  
  

 

Other Key Words: Registered Nurse // HRS // Healthcare Resources // UM // Utilization Management // Case Management 

Department: HRS

Hours: Full-time, 40 hours/week